CHICAGO – Physical exercise, including treadmill, stretching and resistance exercises, appears to improve gait speed, muscle strength and fitness for patients with Parkinson disease (PD), according to a report of a randomized clinical trial published Online First by Archives of Neurology, a JAMA Network publication.

Gait impairment is associated with functional decline in patients with PD and current therapies are inadequate at preserving mobility as PD progresses. There is growing interest in the use of exercise to improve mobility and function, the authors write in the study background.

Lisa M. Shulman, M.D., of the University of Maryland School of Medicine, Baltimore, and colleagues conducted a randomized clinical trial of three types of physical exercise to compare the effectiveness of treadmill, stretching and resistance exercises in improving gait speed, strength and fitness for patients with PD.

The study included 67 patients with PD who had gait impairment and were randomly assigned to one of three groups in the trial: a higher intensity treadmill exercise (30 minutes at 70 percent to 80 percent of heart rate reserve); a lower-intensity treadmill exercise (50 minutes at 40 percent to 50 percent of heart rate reserve); and stretching and resistance exercises (two sets of 10 repetitions on each leg on three resistance machines). Patients performed the exercises three times a week for three months.

"The effects of exercise were seen across all three exercise groups. The lower-intensity treadmill exercise resulted in the greatest improvement in gait speed. Both the higher- and lower-intensity treadmill exercises improved cardiovascular fitness. Only the stretching and resistance exercises improved muscle strength. Therefore, exercise can improve gait speed, muscle strength and fitness for patients with Parkinson disease," the study notes.

"The fact that the lower-intensity treadmill exercise is the most feasible exercise for most patients with PD has important implications for clinical practice. Although treadmill and resistance training are beneficial for gait, fitness and muscle strength, these benefits were not accompanied by improvements in disability and quality of life," the authors conclude. "Future directions for study include trials of combinations of exercise types, longer training periods and investigation of the potential for exercise to modify the trajectory of disease progression over time."

(Arch Neurol. Published online November 5, 2012. doi:10.1001/jamaneurol.2013.646. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: This study was supported by a grant from the Michael J. Fox Foundation. Additional resources also were provided from other sources. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Benefits of Exercise in Parkinson Disease

In an editorial, Liana S. Rosenthal, M.D., and E. Ray Dorsey, M.D., M.B.A., of The Johns Hopkins University School of Medicine, Baltimore, Md., write: "In this issue of the journal, Shulman and colleagues offer compelling evidence that exercise can improve gait and fitness among individuals with PD."

"This research adds to the evidence regarding the value of interventions for PD beyond medications and surgery and offers an opportunity for patients to be active participants in their care," they continue.

"Exercise programs among those with neurological disorders increase the patients' sense of self-efficacy, their sense of involvement in their care and overall belief in their abilities to perform certain activities," they conclude. "In essence, exercise puts the patient – not a pill – at the center of care, which is exactly where patients want and ought to be."

(Arch Neurol. Published online November 5, 2012. doi:10.1001/jamaneurol.2013.772. Available pre-embargo to the media at http://media.jamanetwork.com.)

CHICAGO – Physical exercise, including treadmill, stretching and resistance exercises, appears to improve gait speed, muscle strength and fitness for patients with Parkinson disease (PD), according to a report of a randomized clinical trial published Online First by Archives of Neurology, a JAMA Network publication.

Gait impairment is associated with functional decline in patients with PD and current therapies are inadequate at preserving mobility as PD progresses. There is growing interest in the use of exercise to improve mobility and function, the authors write in the study background.

Lisa M. Shulman, M.D., of the University of Maryland School of Medicine, Baltimore, and colleagues conducted a randomized clinical trial of three types of physical exercise to compare the effectiveness of treadmill, stretching and resistance exercises in improving gait speed, strength and fitness for patients with PD.

The study included 67 patients with PD who had gait impairment and were randomly assigned to one of three groups in the trial: a higher intensity treadmill exercise (30 minutes at 70 percent to 80 percent of heart rate reserve); a lower-intensity treadmill exercise (50 minutes at 40 percent to 50 percent of heart rate reserve); and stretching and resistance exercises (two sets of 10 repetitions on each leg on three resistance machines). Patients performed the exercises three times a week for three months.

"The effects of exercise were seen across all three exercise groups. The lower-intensity treadmill exercise resulted in the greatest improvement in gait speed. Both the higher- and lower-intensity treadmill exercises improved cardiovascular fitness. Only the stretching and resistance exercises improved muscle strength. Therefore, exercise can improve gait speed, muscle strength and fitness for patients with Parkinson disease," the study notes.

"The fact that the lower-intensity treadmill exercise is the most feasible exercise for most patients with PD has important implications for clinical practice. Although treadmill and resistance training are beneficial for gait, fitness and muscle strength, these benefits were not accompanied by improvements in disability and quality of life," the authors conclude. "Future directions for study include trials of combinations of exercise types, longer training periods and investigation of the potential for exercise to modify the trajectory of disease progression over time."

(Arch Neurol. Published online November 5, 2012. doi:10.1001/jamaneurol.2013.646. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: This study was supported by a grant from the Michael J. Fox Foundation. Additional resources also were provided from other sources. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Benefits of Exercise in Parkinson Disease

In an editorial, Liana S. Rosenthal, M.D., and E. Ray Dorsey, M.D., M.B.A., of The Johns Hopkins University School of Medicine, Baltimore, Md., write: "In this issue of the journal, Shulman and colleagues offer compelling evidence that exercise can improve gait and fitness among individuals with PD."

"This research adds to the evidence regarding the value of interventions for PD beyond medications and surgery and offers an opportunity for patients to be active participants in their care," they continue.

"Exercise programs among those with neurological disorders increase the patients' sense of self-efficacy, their sense of involvement in their care and overall belief in their abilities to perform certain activities," they conclude. "In essence, exercise puts the patient – not a pill – at the center of care, which is exactly where patients want and ought to be."

(Arch Neurol. Published online November 5, 2012. doi:10.1001/jamaneurol.2013.772. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: Conflict of interest disclosures include one author who serves as a consultant and another author who receives research support. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding a

National Posture Institute just launched its membership subscription to all the fitness/health professionals, as well as the general public. The membership will allow you to get access to all the member-only workshop discounts, product discounts, as well as NPI’s highly-demanded archived webinar library.

CHICAGO --- Women who exercise regularly spend as much time sitting as women who don't, according to a new Northwestern Medicine study.

Emerging research shows that prolonged sitting has significant health consequences---and the new Northwestern study suggests that being a dedicated exerciser doesn't prevent women from spending too much of their day sitting.

This research is the latest indication that public health recommendations should be established to encourage Americans to limit the amount of time they spend sitting every day, said Lynette L. Craft, first author of the study and an adjunct assistant professor in preventive medicine at Northwestern University Feinberg School of Medicine.

"We all know someone who gets a good workout in every day, but then spends a large portion of their day sitting in front of a computer with few breaks," Craft said. "If these people could replace some of the sitting with light activity---just getting up, moving around, maybe standing up when talking on the phone, walking down the hall instead of sending an email---we do think they could gain health benefits."

The Northwestern research was done in collaboration with Ted Zderic, of the Pennington Biomedical Research Center and was published in the International Journal of Behavioral Nutrition and Physical Activity.

Past studies have shown that people who sit for extended periods of time---even those meeting exercise recommendations---are more likely to develop chronic conditions such as diabetes, obesity, cardiovascular disease and some cancers.

This was the first study to use an objective measuring device to examine the relationship between the type of exercise recommended in the government's Physical Activity Guidelines for Americans and sitting. The guidelines recommend adults engage in a minimum of 150 minutes of moderate intensity aerobic activity every week. Previous studies on physical activity and sitting have primarily relied on self-reported data.

While many of the women in the study met or exceeded 150 minutes of physical activity per week, in reality only a fraction of the women's days were spent being physically active. The women in the study spent an average of nine hours a day sitting. That number is consistent with previous results from much larger studies that examined the number of hours Americans spend sitting every day.

"I think some people assume, 'If I'm getting my 30 to 40 minutes of physical activity a day, I'm doing what I need to do for my health,'" Craft said. "Of course, exercise is very important and is associated with many positive health benefits, but negative health consequences are associated with prolonged sitting, and this study shows that just because you're physically active doesn't mean you're sitting less."

For the study, 91 healthy women ranging in age from age 40 to 75 wore an activPAL activity monitor device during waking hours for one week. The device, which was worn on the thigh, recorded time spent sitting, standing and stepping, and engaging in sustained 10-minute bouts of moderate-to-vigorous physical activity.

Trying to replace some sitting time with more light activity throughout the day---along with the recommended bouts of moderate and vigorous exercise---is an approach more Americans should try to take, Craft said.

Future studies are needed to further examine the relationship between the type of exercise recommended in the Physical Activity Guidelines for Americans and sitting. For example, various subgroups such as men, children and the elderly should also be studied, Craft said.

Welcome to the Fitness Professional Online Radio Show where you get access to fitness industry news, tips and insights from professionals around the world. Visit us at FitnessProfessionalOnline.com and now, your host, Doug Holt.

Doug Holt: Hello and welcome and to the next episode of Fitness Professional Online Radio Show. I'm your host, Doug Holt, and I'm happy to be with you here today. We have a great show for you today. We have an interview with Ken Baldwin. And before we get into that, want to let you know of a few updates. I'm talking a little fast it's just because I had my coffee so I'm ready to go. Just got back from a great weekend up the coast at California in Big Sur, great mastermind meeting. There's a lot of great new business ideas and kind of breaking those down through the industry. Special shout out to the chiropractor on the trip, you know who are. Christian, that was a great talk we had and I look forward to a lot of things in the future which we'll be sharing online.

And you'll see in the new October issue some of the stuff that I was talking about with the mastermind group is prepping for the holidays. Even though we are coming here to October as health and fitness practitioners, it's really important to gear your marketing and your plan, you already should have one. But if you don't, really hone that in for the holidays and coming into the New Year. It's always better than rushing into it and kind of guessing what you want to do when it happens. Kind of that, "Oh, shoots November." "Oh, shoots December." So, we'll have that on FitnessProfessionalOnline.com. We'll share with you some of our mastermind ideas, got an approval from that group to do so. But let's get into the interview. This is a great one.Ken Baldwin joined the State University of New York, Plattsburgh's Department of Sport and Wellness as an Assistant Professor and the Program Coordinator for the Fitness and Wellness Leadership Major in August 2007. Prior to working at SUNY Plattsburgh, Ken was the Coordinator/Instructor for Purdue University's Personal Fitness Training Major and the Assistant Director at Purdue's A.H. Ismail Fitness/Research Center. Ken has received national recognition from numerous media outlets including Newsweek, L. A. Times, Chicago Tribune, Indianapolis Star, Athletic Business, WRTV-TV 6, MSNBC.COM, the Associated Press, IDEA Fitness Journal, New York Newsday, Club Industry, IHRSA, and Personal Fitness Professional for establishing academic programs and degrees focusing on fitness, exercise science, and personal training profession.

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In addition, Ken is the Exercise Director for the National Posture Institute (NPI), an educational and professional organization that provides certificate programs for personal trainers, group instructors and allied medical and fitness professionals to receive the National Posture Institutes, "certified posture specialist" designation. NPI is dedicated to delivering to personal trainers and current allied health/medical/fitness professionals the collegiate educational system, the media and general public information education on posture and body alignment through innovative educational resources, teaching business solutions, courses and the NPI certified posture specialist.

The National Posture Institute website which will be in our show notes, Ken has been involved in the fitness, wellness and educational profession for over 15 years. With an extensive background in the fitness industry which includes operating and managing a personal training company to training many types of populations from children to seniors and beginning exercises to athletes to lecturing and consulting at the college university departments, public events, national conventions, ACSM, health and fitness summit, Club Industry, IDEA World Conferences, the AAHPERD, Canadian Fitness Professional Conference and the Medical Fitness Association to name a few and international conference. In addition to his industry experience, he is actively involved in working with national organizations and colleges and universities in developing educational standards for those wishing to enter the training and fitness professional.

Ken is also the former chair of IDEA's National Personal Trainer Committee, Chair of the Senior Fitness Sub-Committee for the Massachusetts Governor's Committee on Physical Fitness and Sport and was an elected Board Member to the Massachusetts Governors Committee. He has served on national committees with organizations that include the American Colleges Sports Medicine, Life Fitness Academy, AAHPERD and the Medical Fitness Association. He's been awarded Austin's Best Personal Trainer three times and is a recipient of IDEA's National Personal Trainer of the Year. Ken is the Senior Editor, Content Expert and lead author for ACSM's Research on Personal Trainer textbook 2nd edition. What a mouthful, Ken. You've done just about everything. Let's get Ken on the call.

Doug Holt: I know you have done so much in the industry but for those that don't know, tell us a little bit about yourself. And on your path on the fitness industry, how you got where you are today.

Ken Baldwin: Sure. Well, I'm a fulltime Assistant Professor at the State University in New York and I oversee an undergraduate program in Fitness and Wellness Leadership. I'd like to say about one-third of our students are interested in becoming personal trainers or group exercise instructors. The other third are interested are going into physical therapy or chiropractry and the other third are interested in becoming athletic trainers and getting into sports conditioning. And prior to being at SUNY, I was at Purdue University where I put together Purdue's first 4-year degree program in personal training. And then prior to Purdue, I was at St. Augusta State University and put together St. Augusta State University's personal training certificate program which is a short 6-month program.

And before working at academia, I owned my owned personal training business and I had about 15 trainers that worked for me that range from working with young children, older adults and we work with corporate executives, to college and professional athletes. And each staff member had unique backgrounds and their own history. I had physical therapists and staff, trainers that had cardiac rehab specialization and then we had trainers that could work with all these different types of age groups in different levels. And that's a little bit of my background.

Doug Holt: So you went from owning your own business which I can relate too being very difficult to academia and running these programs that kind of shaping the industry. What made you make that leap? How did you decide too?

Ken Baldwin: That's a great question. When I was running the personal training business, I had a great opportunity to work at the state level and share the senior fitness sub-committee for the Massachusetts Governors Counsel in Physical Fitness and Sports. I made a lot of connections there with that committee and the Board that I was on. And that lead to an opportunity through IDEA and I'm sure you're familiar with IDEA. They're based on San Diego and they have 20,000 personal trainers and group exercise instructors and that opportunity lead me into Chair-ing their National Personal Trainer Committee and the opportunity go into academia. Really kind of live from IDEA based on San Diego to that opportunity at San Diego State University.

Doug Holt: Okay. Now, I definitely understand where both of those are. I'm very familiar actually with San Diego State University Program. I went through something similar at University California, Santa Barbara when it first came out but that was back in the late '90s dating myself a little bit. So, I was very familiar with that program as well. I know you did a good job of that. Give me kind of a day-to-day life and I know there's never a typical day. Everybody always says that I'd certainly not want my life but with all you're doing, what could somebody listening to this has no idea what to expect in the academic background or in all the things that you're developing. Give me a day in a life of Ken.

Ken Baldwin: Everyday starts off usually early in the morning. I'd say, between 5:30 and 6:00. I usually do most of my early writing early in the morning and that's where I am most creative. So, I might be working on an article or we're working on a textbook right now for the organization. And it's usually using my creative stuffs early in the morning and then when I get to the university, anything can happen. Usually, there could be committee meetings or I could have meetings with students. And of course, depending on the semester, I maybe teaching anywhere from 3 to 4 classes each semester and I also oversee all the students clinical rotations.

Our degree programs were really unique and students when they are getting into their junior or third year on the degree program, they actually spend every semester, they're in a clinical rotations. So, we have students that are in a cardiac rehab setting, physical therapy setting, they maybe at a sports performance clinic either on campus or offsite. So, I'm usually communicating with each of the directors at our clinical sites making sure that our students are doing well and then we've got a lot of stuff going on at the university whether it's research or committee or curriculum committees or educational meetings and we're working on creating some online master degree programs right now too in fitness and exercise science.

Doug Holt: That's fantastic. And besides all that, you also of course have NPI, right?

Ken Baldwin: Yes. For the National Posture Institute, usually, I'll work those types of things later on in the day, anywhere from like 4 o'clock on, and usually depending on the weeknight, kind of late into the night actually, and then on the weekends too I might be working on some stuff for National Posture Institute. And then we have conferences that where we're at where a lot of different conferences, might be a club, industry conference, IHRSA, or IDEA's conference, or SCW or DCAC. So we present onsite workshops to different conferences, and then we may go into facilities like health clubs, or physical therapy clinics or medically based fitness facilities, or we do training and education on site as well. So my days are pretty busy, I'd say.

Doug Holt: I'd say, too! I'd say your weeks are pretty busy.

Ken Baldwin: Very much.

Doug Holt: That's a job of four people right there. A true entrepreneur, I love it. Well, tell me a little about the National Posture Institute. How'd that come about and how did you kind of narrow your focus on Posture in particular?

Ken Baldwin: Posture goes way back to when I was doing my personal training and when I first started after college. And it's one thing that I noticed really on actually when I was student in college, I noticed a lot of my friends either in my classes or on the sports teams that had issues with posture and body alignment. And when I started exercising, I really made sure that when I first started practicing and learning all these different exercise movements, that I didn't really worry so much about the weight, but I was kind of working on making sure that I could feel the muscle groups working properly. So if I was doing a dumbbell chest press, I may not be using fifty pounds, but I may be using 20-pound dumbbells, going through the movements slowly and practicing.

So for myself I noticed early on other people performing exercise movements that weren't in good, what I would say, in good alignment, and I was only 18 or 19 years old at the time but just noticing that. And then when I started training my clients, and seeing clients come to us from different age groups like working with, let's say a 10- or 12-year-old or an older adult I noticed that everybody had some kind of postural issue, whether it was forward head protrusion, around and back called exaggerated kyphotic curve or somebody had a lot of internal rotation in their shoulders. Well, I noticed when I would teach an exercise movement, I would try to get them in a correct position or correct posture alignment as they performed one repetition.

But they perform one repetition, but as soon as they perform that one repetition, after I had them in good alignment, I noticed their body would revert back to that poor alignment. So rather than letting them continue repetition after repetition in that poor alignment I would make those mental and physical adjustments in their body as they're performing each repetition. So then from there I started incorporating and developing a posture assessment type portion based on some guidelines, so I kind of added that into the fold, and all then all trainers, staff and physical therapists and others in the organization. We started really developing a detailed posture assessment program.

So for the National Posture Institute this organization's made up of colleagues of mine from different college universities that focus on research, body mechanics and kinesiology on posture assessments and how to perform all of these various exercise movements, whether using free weights, tubing, cable machines, body weight exercises, if you're using a selectorized strength training machines, or if you're performing Olympic lifts, or whatever the exercise movement, or rehab-type movement pattern, we've broken down and analyzed the exact position you need to be in to make sure the muscles are activating well, and at the same time the posture and body alignment are being corrected at the same moment.

Doug Holt: So this goes way beyond the typical core involvement when you're talking about this. You actually have a standardized procedure to activate the muscles and get the exact results and keep people I guess in which is neutral spine or natural posture?

Ken Baldwin: Exactly. Exactly. So we identify first, the alignment issues that the person has, so, from head to toe. Then from there, since we know where their strengths and weaknesses are, and where our ideal alignment would be for that individual, then the exercises that we select we want to make sure, that one, we're not teaching them a complicated exercise movement first, because we want them to memorize movement patterns, lock those in and as they start to memorize these movement patterns, their neurological system starts to improve and get better.

So the goal is that that client or patient that somebody is working with or professional, the client or patient, their body eventually will know when they're in good posture and when they're out of good posture, and that's really kind of the neat thing about it. And so as their posture improves, the muscles are going to develop really, really well and balance. So we found we when we're working with, you know we could be working with an 8 or 9-year-old child to older adult to college or professional athlete, that everyone has posture issues, and especially as you know we may only be working with our client or our sports team you know so many days a week, in a strength training facility or health club, or physical therapy clinic, or wherever your setting's at.

So we need to also teach our clients or patients what they need to do during the day when they're sitting at their desk, what they for all their [10:36] daily living and make sure they're doing them safely, so we really kind of look at a holistic approach. Not only are we teaching how to perform all these exercise movements and strengthening movements, we're also teaching them concepts so they can work on their posture and body alignment outside of the facility.

Doug Holt: That's fantastic. So you're actually giving them homework for them to take and take to their actual daily lives.

Ken Baldwin: Exactly. You got it. So it's a whole plan that they work on outside the facility and they're working on it 24 hours a day. We're giving them guidelines on how to sit, safest position for them to sit, positions if they're, doing gardening, when they're brushing their teeth in the morning and washing their face, positions they should be in when they're coughing or sneezing so they don't, injure their back from all the force from their sneezing hurt their ribs. All those types, and of course, are not taught in one session.

If you're working on developing a strong client base and you're working with people, the relationships that I had when doing my personal training, was in back in 1995. Well, from '95 through 2000. The majority of the clients I got in 1995, I was still training them in 2000 when I went and moved to San Diego to go teach at San Diego State University. So I really kind of prided myself from the fact that I was always educating that client every time they came into the facility and they were always learning something new. They were always improving in some way, and those were the things we teach people that go through our education program, whether they're students at the university or they go through National Posture Institute education program, we're very heavy into education, and that the person when they're coming to each session they're learning something new.

Doug Holt: I applaud you. So you must cringe every time you go into a [00:11:55]?

Ken Baldwin: Yeah, I really do. It can be quite scary. And I'll just add this too, Doug, not only personal training, it's also physical therapy, too. Even though someone's gone through a doctor of physical therapy program, it doesn't mean they were taught how to perform all these detailed movements. It takes a lot of practice for a practitioner to get good at doing all these movements, to be able to get good at it themselves, to be able to teach it. So when I got into a facility, could be going into a 24-hour fitness, or I could be going into a medically based fitness facility. It doesn't matter what level, there's always issues with staff, and everyone comes from different educational backgrounds, somebody could come from multiple certificates, and somebody could have a masters or PhD in exercise science, but everybody's different as how they've learned information.

Some people might be good at teaching movements, being good at performing movements themselves, or they may not be. I found in general, 10 percent of the population is really good at performing all of these detailed exercise movements, rehab movements, so it's a small percentage. My goal is that 100 percent, health fitness professionals, and personal trainers, and group exercise instructors eventually learn how to teach these movements really well so they're not hurting people over the course of their career but helping them.

Doug Holt: Amen.

Ken Baldwin: I love it.

Doug Holt: Are you finding more and more Ken that because of our lifestyles are at the computer, sitting down in a car more often, that postural defects are coming up more commonly, or is this that something you've always seen and it's kind of status quo?

Ken Baldwin: Yeah, we really track the research studies in that. So it's amazing the amount of injuries that are happening just from sitting during the day. And it's really in a way, if you think about it this way, let's say you graduate college and you're 22 years old and you're an accounting major, take CPA exam, and then now you're a CPA. If you can imagine, if you've already got forehead protrusion, we find that let's say you're right handed, and your right shoulder is two or three inches lower than your left because you use a mouse, and then you start using a touchpad maybe when you're travelling.

So you've got a lot of internal rotation in your shoulders, then you're in this exaggerated curve, well the majority of the musculoskeletal injuries that the U.S. population has to deal with is pretty much due to sitting all day long. So we really need to when we do our – and I'll go through a little bit later, but our posture is we have to analyze people when they're sitting, because the majority of musculoskeletal disease and issues come from sitting. If you're in San Diego or California, and you only need to drive five or six miles let's say during rush hour, you know that can take maybe an hour, right?

Doug Holt: Absolutely.

Ken Baldwin: So imagine you're that accountant and you've been sitting for eight or nine hours, and then you're like, "Oh, my gosh. Now I got to go home. I'm going from downtown San Diego to Delmar," let's say, Delmar Beach, then you know they're going to be in the car for another hour added on, and another hour where the muscular structures are working isometrically, and if you're not in a good alignment and you're in incorrect posture, then those muscles are working isometrically to reinforce muscular imbalance. And then from those muscular imbalances, they're going to start shifting the skeletal structure and joint structure, these poor positions as one gets older. So over time you can look at somebody who had great posture at 22, have them sit for you know 20 years, and now they're 42 and their alignment can change drastically.

Doug Holt: Wow, I know everybody listening to this, including myself, just stood up and just moved their body around.

Ken Baldwin: It's funny that you said that because that's one of the things we're working on, is okay, how much time are you sitting during the day, and then let's look at ways, where we can have you standing during the day, getting the computer monitor at a new height, getting your phone at new height, so that you're standing for let's say three or four hours out of the day, while you're typing and doing your work, and then let's see you spending three or four hours sitting on a stability ball.

So we're working at development program for people who are office workers or even for like ourselves, we're active individuals but certain portions of the day, you're working on administration, you're working on you know on filling out your client forms, tracking all the exercise programs, you might be doing some social media stuff, keeping in touch with your clients. So you may be on the computer three or four hours a day yourself, plus your six or seven hours of personal training.

So we're trying to look right now at varying up the day, and looking at sitting and standing positions, and some other variables in there and will make more fun than just standing by, you know, standing on two feet, but changing variables around, so you can have some fun activities at the same time.

Doug Holt: Absolutely, well in my training practice, I specialize in entrepreneurs and business owners, I'm seeing more and more with the executives, them, investing in treadmill desks, and standing desks. Back in the internet boom, where I worked for internet companies everybody was sitting on stability balls. Do you see a trend going anywhere today or any specific recommendations or your take home points at somebody listening to this that might be doing a lot more admin than they may want to do, which direction should they go?

Ken Baldwin: I think, this brings up a great subject because the people listening who are listening out there that are personal trainers, this is a great opportunity for you to start working in corporate wellness, and communicating with HR departments on providing exercises plans and programs and then learning about ergonomics, basic ergonomics, and ergonomics of sitting.

So some of the things I would look at are how many hours of that person sitting, and then I do an evaluation of their sitting environment where their computer monitor is, if they're using a touch pad, what type of mouse they're using, the sitting position. So we have to look at how to analyze that, and some of the things that we're looking at. Like I think some of those things you were talking about are great concepts of, standing during the day, and looking at having treadmills put in with appropriate desk attachments to that, and the volume of treadmill walking.

I know some of the larger insurance companies, like Blue Cross and Blue Shield of Massachusetts, they actually have two or three treadmills on a couple of their floors where the employees get a chance to kind of reserve the treadmill for 30 minutes at different points of the day and do their work. So they log in and then they use that computer monitor and do their work and walk on it. And it's really become very popular like at that Blue Cross and Blue Shield of Massachusetts. So I think those are some great things that you bring up, things that allow you to burn some calories during day and also protect yourself from being in this kind of stationary static position at your computer.

Doug Holt: Absolutely. Absolutely. If I were doing an assessment with a client, do I do each client the same assessment, or do I vary the assessment based on client and that client's needs?

Ken Baldwin: That's a good question. I'll give you an example. We like to keep the basic concepts pretty similar, but it'll change if we were working with an athlete. So if we're working with an athlete, we may do some more advanced posture assessments, and range of motion testing for that athlete. But everyone will go through that first baseline kind of structured assessment, and we kind of look at some statics, that's just like doing a standard standing static assessment, where we'll look at the anterior, posterior and lateral views. And we have some really detailed assessment sheets which we'll go through and mark that up.

This takes a lot of time, too. It's not something where all of a sudden you just kind of start doing posture assessments. It takes a lot of detailed thought process, of what you're looking at and understanding all the muscle structures, which ones are short, and which ones are lengthened. Where is the shoulder joint? You know, where's it located right now? If it's dropped down a little bit? Is it diagonal going across the person's body? There's all these different things that we're looking at as we kind of work our way down from the head to down to the feet.

And then from there, from doing that standing posture session, you could look at doing some seated posture assessments, having that person sit in the chair, and taking some photos of them let's say of where their posture is when they're seated. So usually what we'll do is we have some nice posture grids, we have some posture grids put them against the wall with grommets and have it hanging there, or we have posture grids you can purchase, and they have like a banner stand and you can carry with you, if you go to somebody's home or to corporation you bring that with you.

So that you can have the client's that you're working with go against the posture grid and take pictures in that seated or standing position. And you really want to capture those early on in the training sessions, you don't want to wait until a week or two later. And the reason is that we're pretty confident that within that first week, doing the personal training sessions, you should start to see posture changes already in the client you're working with. So you want to take those pictures as early on as possible.

Ken Baldwin: Yes. You don't want to miss one day and say, "Oh, my gosh. I forgot my camera and start telling them the concepts they need to work on. You want to have your camera and grid ready and dedicate that time towards that. And then the posture assessment can get even more detailed from that. We have some posture assessment software that we can take pictures of the client and then put those into this really pretty incredible software that will measure all the deviations or different angles that that person's off from their line of gravity.

So from line of gravity we know that we're kind of connecting from the external [21:40] radius to the acromion process down through sacrum or S-2, then past around the center of the hip joint down to the knee and ankle. But it's really rare that you know you're going to have a perfect line of gravity. And we base everything off that line of gravity. If you have forward head protrusion, a little exaggerated kyphotic curve, going to create these angles we can calculate out and so there's have something we created called "posture number."

And if someone has ideal posture, their line of gravity is going to be at zero. Their zero degrees of deviation throughout that person through all three planes but that's pretty rare. I'll give you an ideal, majority of the population posture number falls between, 35 to 45. That's how bad world-wide peoples' posture is. But what's kind of neat is let's say you have a client whose posture number was 35, and you've identified that in the very first assessment session that you're working with them. And then let's say, two weeks later you retake your photos, you logged them into the software, you kind of connect all these dots, and then you find that they went from a 35 posture number now they're down to let's say, a 27 or a 28. So that's really neat.

So where I kind of see the future going, is that we need to quantify our results as personal trainers and fitness professionals to be able not only show on a scale or through skin calliper somebody getting toned or fit, but really being able to calculate some of these unique numbers, and saying look, you started at a 35 when we first started and now one year later you're in the low teens you're like at a 13 or 14, and now our goal is to get you down in the single digit numbers. Because really the way we kind of present the information, if you can teach somebody to be in good posture body alignment, when exercising or sitting, when they're [23:03] and all that sort of stuff, the chances of them ever getting injured should be zero.

If you teach them how to do all these things, and what I mean zero, is the only way they're going to get hurt they're an athlete out in the field and performing their sport, yeah they might get hurt during that activity but I'm going to make sure they're not getting hurt in the you know strength training or exercising area or when they're doing [00:23:56]. They might get hurt out on the field or on the courts but they're not going to get hurt from that professional, teaching them all this information.

Doug Holt: Absolutely. And it's going to limit chances of injury on the field having that correct posture throughout the day.

Ken Baldwin: Yeah. And that's right. And one thing I was going to mention, I'm really psyched about this, with our degree program we've been working on, I've been working and kind of cultivating this relationship with United States Olympic Training Center in Lake Placid. So we actually signed this past Spring an agreement with them so our students can intern there. But since that time, what we've had is we've had their operations director, and lead sport physiologist, come to our campus and do some really great open lectures to our campus and then we took a field trip down to Lake Placid and had a chance to tour strength training facilities, their living quarters, and their cafeteria, which is open 24 hours a day and they've got the best, healthiest food you've ever seen. Like you could sit there all day and eat with them and it's great.
But we get a chance to see with their lead sports physiologist, and the Olympic training lifts, and the angles, biomechanics, and in which they try to get the athletes in, and they're very keen on posture and body alignment, because they realize that in order for an athlete to gain power strength and speed, if they're not in good alignment, they can't really achieve those results.

Doug Holt: It makes complete sense, though, biomechanically. You brought up a point earlier about the photography and software. If I were, or somebody listening to this were, a certified posture specialist, is this something they could actually conduct the assessments online or remotely, but having somebody else takes pictures? Maybe a husband or a wife?

Ken Baldwin: That's a really great a question. Yes, they can do it on site or they can do it online. I've actually been doing posture assessments online. I think it's been, about 14 years. So yeah, so around 1998, '99, because the results that I was having with clients back in Cambridge, a lot of the clients, they have family members, of course, around the entire United States. So their family members starting taking pictures, and of course, a lot of people didn't have digital cameras, of course, and uploading the cameras and emailing them. They would take pictures of themselves against a grid, then mail them to me and I would assess them, and I would put together an exercise program or plan that they could then work on over a four week period of time. Then take a new set of pictures, send them to me, and I would evaluate them.
And then we're getting into 2000, 2001, and then I was kind of doing away with the mail thing. People would take pictures and email them in. So a lot of our certified posture specialists can not only do it onsite, but online. And not only for individuals but you could do it online for an entire company or organization that has sites maybe not, maybe, they want to make sure everyone not living in their main city where their organization is, they might have offices in other cities, but they want to get those employees assessed as well, and have them involved in a program that they can work on.

Doug Holt: That's a great point. We get a lot of questions about online training. One of the things that's come up with some of my clients that are executives at larger companies, for the HR department, they have to offer the same quality of service, or service offerings to all of their offices. That's been a barrier of entry to some of the trainers that have written in about corporate wellness. So it sounds to me, Ken, if somebody went through your certification they could then actually assess people across the United States and across the world, and therefore the HR departments can offer that service to everybody anywhere, and a trainer that's got more of an entrepreneur spirit can actually pick that up.

Ken Baldwin: Yeah. Thanks for bringing that up. It's just, you know, it's a great way to supplement your income and offer new services, if you, let's say you only wanted to train somebody five hours per day, and the rest of the time you wanted to be home your family. These are some things you can do from your home office, or you know within your office at work, have something you can work on and build a business around that. The one thing I'd like to add to it, because you're working with companies, it sounds like too, and the executives that when we look at musculoskeletal disease and how it fits into the health spectrum these days.

In the past it would usually be heart diseases and diabetes, things with blood pressure and high cholesterol, that's where the majority of your health care expenses would go. But now over the next six or seven years musculoskeletal disease is moving towards that number one spot in most companies and organizations in the United States. So if you look at getting yourself educate and learning how to do posture assess and if you were to go through an educational program, you're really positioning yourself to expand your opportunities to work with, not only the folks in health club and fitness facilities but also branch out and work with companies and corporations, too.

Doug Holt: Yeah. Ken, I've taken I think I have 18 different certifications at this time.

Ken Baldwin: Gosh!

Doug Holt: But I've never found anything like what you and your colleagues have put together. I love the idea that it's a complete package along with a protocol to help people. Posture is something myself and my staff and the trainers I talk to regularly deal with on a daily basis. I've found at least, it's difficult to come up with an exact procedure. And then to give subsequent home work, what I call homework, or exercises for them to do at home, sounds like something you've really kind nailed down.

Ken Baldwin: Yeah, we really kind of think outside of the box. We put ourselves in the position of that employee or that mom at home, or that child that's trying to work on their posture and body alignment, and try to make the education so that it can go across all these different age groups and different types of populations. And I think one of the nice things with technology, we're able to work on and improving our information, our content, develop new programs, coming up in the future that we're working on.

And so, 'm pretty excited about where we're at and where things are going. I think we've positioned ourselves nicely for working with one of the number one health care costs going out there and that's musculoskeletal disease and being able to help people with it. And I can tell you, and you're probably familiar with this, a lot of the population lives in pain. They may have pain in their neck, or their middle back, or their lower back and when you start working with them on getting their alignment improved, those pain and achy pain areas usually tend to start going away. It makes people happy, and I think one of the things is just working with one client, that's where you can really start to really grow and expand. Let's say you're only training 10 or 15 sessions a week, it can really help you if you want to train 30 or 40 sessions a week it will help get you there.

Doug Holt: Absolutely. Well I for one am definitely going to go check out more of the education on your website. I love your website. There's a lot of information on there to digest. I'll put a link in the show notes and on our website so people can go there and directly check it out and get more information from Ken and his team there. Ken as a professor, where do you see the education of trainers going in the next five or 10 years or so.

Ken Baldwin: That's a good question, I get asked that a lot. I'm really excited where things are going right now. For our degree program, it's really unique. We only actually allow 20 students into our degree program every year. We're getting over 200 applications each year. We're getting some really great students, they have high GPA's, high SAT scores, they're just really well rounded kids, and I'd say 20 or 25 percent of them are athletes, too. So they're really bright. And for our university I'm just really happy with where we're at. The reason the degree is unique is because we really try to get them hands on early on in the degree program. We don't wait, most exercise science degree programs, students don't actually take exercise physiology or movement courses until their third year.

We actually created our degree structure so that students start learning and practicing assessments and movements, and we teach how to do these exercises in their freshman year, first semester. Yeah, so I actually just got through finishing up on Monday our posture assessments for the entire freshman class. Next week we're going to start going to the facility and starting to practice those moves. They already know where their weaknesses are. Students will go into the fitness center and have all pictures taken early next week, and so that we work this whole semester in helping them get their alignment better, and at same time we're teaching them a beginning library of exercise, so that they learn to refine and practice and get really good at it so that when we get into next year, and the year after that we start building on that exercise library so they get really good at performing the movements.

But, it's just to add we have them get certified by ACSM in their second year, and during their winter break, so when they come back in their third year in the degree program, we have them actually train a faculty or staff member at the university for every semester thereafter, so they train a new faculty or staff member for the next two years. They may be training their biology professor, their math professor; maybe we have them take business courses, so they may train their marketing professor. So they train somebody new every semester for about 15 to 16 weeks, when they go through that whole cycle of assessments, reassessments, exercise program design for them completely. And they go into a clinical setting rotation starting their junior year. They might spend 16 weeks in cardio rehab. They actually get to sit in surgery and watch a quadruple bypass take place. The surgeon will stand there, hold the heart, point out all the valves, and you know it's just amazing. Students that are in their physical therapy setting, they may be able to get going to surgery and see an ACL surgery take place, a hip replacement, rotator cuff tear surgery, a Tommy John Surgery taking place, as well as not only seeing the surgery, then they see the patient a couple weeks later in rehab, in that clinic.

Our students can go into an older adult setting working with older adults, children's fitness, they can go into our athletic training area, where they get a chance to be under the auspices of our licensed athletic trainers, and they get to work on rehabbing the athletes coming back from injury. Our students that are really mature, they may be able to oversee the entire exercise program as sports conditioning program, for a team during their off season.

So, one of my students is overseeing the entire lacrosse team. So their sport's in the spring, but he's getting up early in the morning, seeing all the entire team, making sure they're working out, increase their speed, strength and agility. They just get all these awesome opportunities. What I've seen in national level, degree programs are starting to change so that students are starting to now, take these early on activity, or practical type courses, not waiting until the end like their junior or senior year.

Doug Holt: Yeah, it's aligning with their passion, or kind of the reason why they're getting into the industry, rather than waiting you know two, three years later. It seems so intuitive.

Ken Baldwin: Yeah, yes, and you know it takes so long to learn and get good at these thousands of exercise movements that you can learn.

Doug Holt: Absolutely.

Ken Baldwin: Right? It's not like a golf swing where you have one movement you're trying to memorize, but hundreds of them.

Doug Holt: Why do you think it's taken so long for anybody else to grasp that?

Ken Baldwin: The degree structure? The way things are?

Doug Holt: Absolutely, the way they have it set up, introducing students right away to exercise assessments and the exercises, and getting them kind of, getting their hands dirty, so to speak.

Ken Baldwin: I had to go back and I did a lot of research of how degree programs are structured, going back to the 1940s, and '50s, and '60s and they really originated with physical education type degrees. And then from there, they started expanding into exercise physiology with a lot of research. So there were a lot of research laden professors at universities, with less of that kind of practitioner practical skills set, that they'd learned previous to becoming a professor. So with having a lot of professors focusing on research and not really having a background in movement, that skills set was usually missing.

So that's where a lot of colleges are looking to in a way looking for local personal trainers, probably that have a minimum degree of a master's degree, where they can come in and maybe teach a personal training course to their students that are maybe Exercise Science or Exercise Physiology degree. So they may only have one course in it, but that's better than having no course, because I reviewed a lot of degree programs from around the United States. Probably over 400 degree programs I looked at in every single state and looked at all strengths and weaknesses. And when I went through I found almost half of the exercise science degrees, didn't really even have one practical, what I would say, a resistance training or strength training course required in that degree.

Doug Holt: Wow. That's shocking.

Ken Baldwin: I couldn't believe. I could not believe it. That there was not one course like that, for an entire four year degree program.

Ken Baldwin: I know the word is spreading. And we're getting applications from, normally, where we're based in New York, upstate New York, but we're getting them from all over now. Internationally, too.

Doug Holt: Personal note, as a west coast guy in San Diego, is it a hard transition making it to the east coast.

Ken Baldwin: Yeah.

Doug Holt: It would be.

Ken Baldwin: Especially where we're at. I'd like to invite you out here, but the only time I think you'd feel comfortable out here would be between May, late May and I'd say late September. I think it was the second year I was here, it got down below 20 degrees in October, and it never got higher than that until late March or April. It was one of the coldest winters. And it can get down to zero here, and with the wind it can be in the minus 10 to minus 20 degrees. So I remember living in San Diego, and I think the lowest it ever got was maybe 45 or 50 around December and but pretty much always around that 65 to 70 range most of the time.

Doug Holt: San Diego couldn't dare school out of that weather.

Ken Baldwin: No, you wouldn't like it. But you know one thing that's pretty cool is the athletes in the class, they come from all around the United States, so they have to get used to it pretty quickly. They have to get used to it, the cold weather.

Doug Holt: I'm sure they do [laughter]. That's great. I don't want to keep you. Can you leave the listeners here with what's next for Ken? Where do you see yourself going, five years from now, as well, and what can you leave them with?

Ken Baldwin: Sure, I love being at the university I'm at, and I see us really moving forward with, overall with our department and we're working on creating some master degree programs. We're looking at partnering with different organizations, to write a really nice educational platform for everybody. And then for the National Posture Institute I mean, I think really the sky's the limit. There are new things happening every day. More people are learning about us. They're becoming more interested, and not only professionals, but personal trainers, but group exercise instructors, pilates, and yoga. They're getting more interested. Athletic trainers are starting to say, "You know what, I need to start looking at doing posture assessments for athletes before I start training them." So we're seeing that come on board too.

For our workshops we've gotten those approved through the National Athletic Training Association, workshops been approved by 10 physical therapy states, like Florida, and Texas, physical therapy and things like that, and I think we've been approved by about 10 personal training type organizations, too. So I just see things growing really very quickly, and we're looking at all sorts of things. We're looking at clothing, shoes, and software, and ways to test and analyze balance and stability based on somebody's posture and body alignment, looking at testing muscle structures for integrity and for quality. And just making sure that if the muscles are being trained and developed, that they're being trained and developed evenly and balanced so that that entire muscle structure, like the latissimus dorsi, that every square inch of that is developed fully. So we're looking at everything right now. And as far as assessments go, for performance, for ergonomics, and making sure that people stay healthy.

Doug Holt: For those listening, go check out Ken at npionline.org. Where else can they find you, Ken?

Ken Baldwin: Also, we have a pretty strong Facebook presence. So you can go to the National Posture Institute's Facebook, we also have a blog, we have monthly webinars that take place. So if you want to tune in, and, and attend a lecture presentation, and you're a busy person, you can sign up for a webinars. We have a newsletter, too, that you can sign up on so that way you can kind of keep in touch of the different activities that we're working on. And also, if you're interested ever in attending onsite workshops, our schedules are uploaded there.

If you're a facility like a YMCA, or a health club, or a college recreational center and you'd like to have us come in and do a posture continuing education workshop at your facility so that your staff can get their continuing education credits, you want to have physical therapists and athletic trainers also get their cc's then you can have us host a workshop at your facility and then of course you can go through our online education, too. We've been heavily involved in online education. So we have all of our programs available through online education. And we have a lot of DVD's that we've come out with too. Resistance training DVD's, goniometry DVD's, things like that, so you can always do that, you can always reach me at via email at ken@npionline.orgThis email address is being protected from spambots. You need JavaScript enabled to view it. , and send me a note or send me a message if you have any questions.

Doug Holt: Great. I'll put all that on our site, too so those of you on the treadmill or driving in a car right now, just log onto FitnessProfessionalOnline.com and I'll have all those lined up for Ken so you guys can all get a hold of him them. And then Ken hopefully I'll talk you into getting out to Santa Barbara sometime and work with our staff. I'd love to have you out here.

Ken Baldwin: Thank you Ken for being on the show. I really appreciate it. Very impressed with all you've done in the industry and all you're doing to raise the bar, can't thank you enough from all of us here at Fitness Professional Online and all of us here in this industry. That's it for this show. I'm off to a backpacking trip up in Mammoth Mountain. Wish you all the best and enjoy your week.

Thank you for listening to the Fitness Professional Online Radio Show. You can share your thoughts and join the discussion on this episode by going through our website or on Facebook.com/FitProOnline. Let us know what you'd like to hear on future shows and please feel free to contact us via e-mail or give us a call at (805) 500-6893. We look forward to hearing from you.

National Posture Institute Research Review-Food waste reduced by tray elimination in university dining hall experiment. Impact on Plate Waste of Switching from a Tray to a Trayless Delivery System in a University Dining Hall and Employee R...

esponse to the Switch. A potential strategy for decreasing food waste in foodservice operations is trayless dining.

The objective of this 2010 study was to compare the impact of using a tray vs a trayless system on plate waste and on employees’ attitudes.

To test the hypothesis that going trayless would reduce waste, liquid and solid plate waste were measured for 1 week with the then-existing tray system and again after a new trayless system was implemented in a buffet-style university dining hall serving roughly 1,000 meals a day.

Foodservice staff were invited to participate in a focus group about the impact on their jobs.

The investigators calculated plate waste per patron under the two systems and used an independent samples t test to examine the significance of the difference.

Comments from the focus group were analyzed for themes.

A significant decrease in solid waste per patron (0.81 oz; P=0.001) was observed in switching from the tray to the trayless system (4.39±0.24 oz vs 3.58±0.08 oz per patron).

Most of the employees preferred the trayless system as long as it did reduce waste, but felt that increased breakage of dishware and increased need to wipe down tables were possible concerns resulting from the switch.

This study demonstrates that trayless dining can reduce plate waste, and that employees can be supportive of the change.

Ken Baldwin, Assistant Professor at the State University of New York, Certified Posture Specialist, and Executive Director of National Posture Institute will be hosting a webinar on November 7, 2012 (Wednesday) at 7-8 PM (EST). The webinar titled "Designing Resistance Training Programs for the Arms (Biceps/Triceps) in Correct Posture" will go in-depth to show you the anatomy, biomechanics and physiology of a given exercise movement for the Arm Muscle Groups, how typical exercise movements for the Biceps and Triceps are commonly performed incorrectly, and how to correct each movement based on your clients/patients ability and current postural status.

2. NPI Affiliate Program- Providing Health Clubs/Allied Health-Medical Facilities successful business solutions through the integration of NPI's certificate and Posture Assessment Program to retain and build a large client/patient/membership base as an NPI Affiliate.

Registration/Contact Information:
If you are interested in registering or learning more about the National Posture Institute's (NPI) - Certificate Programs, Onsite CEC Workshops, Products, or Services - please contact us at: Email info@npionline.org, Phone-888-240-2914, or visit our Website www.npionline.org or "Like Us" on Facebook- National Posture Institute Facebook MEDIA and NEWS OUTLETS may contact us at media@npionline.org